Psychoanalysis is a therapeutic process that focuses on an individual's unconscious and deep-rooted thoughts. It takes the view that our current behaviour, thoughts and feelings are directly influenced by our childhood and past experiences. Over time these can become repressed and may manifest themselves as depression or other negative symptoms.
Developed by leading psychotherapist, Sigmund Freud, psychoanalysis therapy is widely used to help clients recognise and understand how unconscious factors affect their current relationships and patterns of behaviour. Through techniques such as free association and dream analysis, clients can learn how to interpret deeply buried and complex memories or experiences that may be causing them distress and preventing them from living life to the fullest.
The ultimate aim of psychoanalysis is to foster deep-seated change and emotional development - particularly in those who suffer from limiting psychological disorders. Clients are expected to see improvements not only to their mental and physical health, but also to their sense of well-being and to their ability to manage their lives more effectively.
This branch of psychotherapy is typically delivered long-term, requiring a level of time and commitment from the client. It is the delivery time frame that sets psychoanalysis apart from psychoanalytic and psychodynamic therapies - two branches of counselling which share similarities in approach but are generally short-term.
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How does psychoanalysis work?
There are four key assumptions that guide the process of psychoanalysis. These are:
- Psychological problems are rooted in the unconscious mind.
- Manifest symptoms are the result of latent (hidden) disturbances.
- Unresolved issues or repressed trauma are typical causes.
- Treatment is designed to bring the repressed conflict into consciousness, so a client can make the necessary changes to overcome them.
The treatment process also relies heavily on other factors including a strong relationship between client and therapist. As with many talking therapies, a psychoanalyst must provide a private and confidential setting in which to foster a trusting and authentic relationship with their client(s). They will need to convey both insight and emotional understanding to ensure a non-judgemental and supportive stance throughout the entire process.
This relationship will help to facilitate a core process of psychoanalysis, which is called "transference". Transference takes place when the client freely talks about his/her feelings and thoughts towards important people in their life - essentially living out his/her unconscious dynamics through the connection to the therapist. As their difficulties gradually begin to appear, the therapist helps to clarify them. In turn, the client refines, corrects, rejects or adds further thoughts and feelings. Over the course of therapy the client and therapist will collaboratively analyse these insights - a process which creates a real-time sense of the client's unconscious dynamics. Eventually the client will be able to start modifying life patterns and removing limiting symptoms.
Generally, psychoanalysis therapy is a long-term, intensive treatment that involves considerable commitment from both patient and therapist. Clients are usually required to attend regular sessions for several years - depending on their individual needs and personal circumstances. Regular sessions allow for in-depth exploration and interpretation of these unconscious patterns.
Methods used in psychoanalysis
A range of techniques will be employed in psychoanalysis to enable the client and therapist to interpret and make sense of deeply buried memories and experiences that are expressed during therapy. Although free association - the client speaking freely about any subject or topic they feel comfortable with - tends to preside over others, all are significant in fostering the change and personal development that characterises psychoanalysis therapy.
Freud believed that all people learn through myths, jokes, fairytales, poems and linguistic languages - symbols which are also used in our dreams. In psychoanalysis, dream analysis involves the interpretation of these symbols to understand the unconscious mind and indicate any areas of trouble that need to be investigated. The client is required to recall the dreams that are recurring and/or traumatic so that the therapist can hone in on specific areas (symbols) of concern.
This technique is based on Freud's assertion that our dreams are a disguised fulfillment of a wish, and that the disguise is caused by repression (latent thoughts that stem from past experiences). It is revolutionary in the sense that it goes beyond simply analysing the manifest content of the dream. Although Freud did not explore the cross-cultural differences in the significance of dreams, therapists using this method will generally be flexible in their interpretation.
Typically used early on in psychoanalysis therapy, word association involves the therapist giving a stimulus word, to which the client must reply with the very first thing that comes into their head. This enables unconscious thoughts to enter the conscious in preparation for further investigation later on in the therapy.
In some cases, psychoanalysts will present clients with a series of abstract images, and will invite them to explain what they see, or create a story based on the images. Freud believed this technique allows the unconscious to become conscious - helping clients to unlock their inner thoughts and desires. A common projective test used in psychoanalysis today is the blot test. Invented by Hermann Rorschach in 1928 this involves ten specially-designed ink blot images.
Freud believed unconscious thoughts and feelings could transfer to the conscious mind through para praxes - minor slips of the tongue or pen. These 'Freudian slips' (as they are also known) can reveal a client's real thoughts and motivations - often those which are consciously suppressed as a result of past experiences and/or memories. Psychoanalysts take the view that every slip is significant and can reveal something important, so they keep a close watch for these during therapy.
Who can benefit from psychoanalysis?
Psychoanalysis is a highly individualised therapy, and thus can help to treat a range of psychological disorders and self-destructive patterns of behaviour that may be impacting quality of life. It does however tend to be more beneficial for someone who - no matter how incapacitated at the time - is potentially a sturdy individual. This person may have already secured important life satisfactions such as a good career and healthy relationships, but is nonetheless greatly troubled by long-standing symptoms and problems. These may include depression, anxiety, sexual issues, personality disorders or physical symptoms that do not have any demonstrable underlying cause.
The therapy can help clients of all ages and can even benefit those who are just curious to know a bit more about themselves and how their mind works. Essentially though, it is for people who have concerns that interfere with the way they want to live their lives. Psychoanalysis allows them to address their internal conflicts and increase self-understanding and freedom from latent thoughts and patterns of behaviour that are limiting life satisfaction.
What our experts say
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Helen Swords MA UKCP10th November, 2015